CRC WI RD LLC (NPI# 1861773863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861773863 |
| Entity Type | Organization |
| Organization Name | CRC WI RD LLC |
| Other Organization Name | BURKWOOD TREATMENT CENTER |
| Practice Address |
615 Old Mill Rd Hudson WI 54016-6959 |
| Practice Telephone | 7153866125 |
| Practice Fax Number | 7153810158 |
| Mailing Telephone | 7153866125 |
| Mailing Fax Number | 7153810158 |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2011-09-02 |
| Authorized Official Name | MS. KATHRYN MARIE IHUS (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 7153866125 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
1118 | WI | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Burkwood Treatment Center | Doing Business As Name - Organization |
| Street Address |
615 OLD MILL RD |
| City | HUDSON |
| State | WI |
| Zip Code | 54016-6959 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356412506 | Burkwood, Inc. | Substance Abuse Rehabilitation Facility | 615 Old Mill Rd, Hudson, WI 54016-6959 | 2006-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164921128 | Sara Lynn Henry | Occupational Therapy Assistant | 1320 Wisconsin St., Husdon, WI 54016 | 2018-02-06 |
| 1689003436 | Serving Hands Inc | Home Health | 1419 Boulder Court, Hudson, WI 54016 | 2013-11-02 |
| 1275973042 | Lisa Renee Haverly | Occupational Therapist | 477 Perch Lake Rd, Hudson, WI 54016 | 2013-06-26 |
| 1710320213 | Emily Ann Stevenson | Counselor | 901 4th St Ste 165, Hudson, WI 54016 | 2013-04-15 |
| 1083972954 | The Shurden Group | In Home Supportive Care | 2424 Monetary Blvd. #012, The Shurden Group Dba Comfort Keepers, Hudson, WI 54016 | 2012-04-30 |
| 1124305933 | Robert Michael Catlow-price | Massage Therapist | 131 Carmichael Road, Suite #202, Hudson, WI 54016 | 2011-11-08 |
| 1962780221 | Qin Chu | Acupuncturist | 1615 Maxwell Dr., Suite D, Hudson, WI 54016 | 2011-08-03 |
| 1124324231 | Hung Trieu Lieu | Acupuncturist | 1810 Crest View Dr Ste 4a, Hudson, WI 54016 | 2011-02-07 |
| 1912214966 | Sumac Residential LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 723 B Blue Jay Lane, Hudson, WI 54016 | 2010-09-10 |
| 1740593201 | Michelle Marie Young | Counselor | 2501 Hanley Road, Suite F, Eagle Valley Bank Building, Hudson, WI 54016 | 2010-07-26 |
| Find all providers in zip 54016 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1245628817 | Forever Free Substance Abuse and Mental Heath Treament Center | Clinic/Center | 724 S Layton Blvd, Milwaukee, WI 53215-1224 | 2015-01-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.